The majority of periodontal or gum diseases are progressive in that they begin with early inflammation known as reversible gingivitis where bacterial plaque, over a period of time, makes gums red, puffy and tender with occasional bleeding. Black gum disease, a necrotizing type of condition, differs from the progressive process of most disorders because black gum disease can become serious very quickly and requires immediate medical treatment. This disease, also known as necrotizing ulcerative periodontitis, or NUP, not only infects but also kills tissue; that is, the black tissue is the necrotic or dead tissue.
In addition to the severe destruction of NUP that extends to bone, another reason that medical care is critical is that NUP indicates a major immune suppressive dysfunction.
Professional examination may include the following presentation of signs and symptoms:
Black and necrotic, that is, dead tissue.
Deep ulcerations at the edge of gums into the bone; these osseous "craters" have a distinct appearance in contrast to other disease processes. According to AIDS Education and Training Centers, or AETC, several cases exhibited necrotic bone as well as necrotic areas of the proximal mandible and maxilla.
Onset of sudden and severe "deep" jaw pain.
Foul odor or breath.
Spontaneous bleeding in oral area
Metallic taste in mouth
Malnutrition, usually due to inability to chew and eat food
Blunted interdental tissue space, normally cone-shaped in appearance.
Black gum disease is an acute situation. Several risk factors have been identified for this necrotizing disorder and may include the following: viruses, autoimmune disorders, HIV, stress, inadequate nutrition and smoking. According to the AETC, NUP is the most severe dental disease that occurs in individuals with an AIDS or HIV diagnosis; also, NUP prevalence in the general HIV population is somewhere between 0 and 5 percent.
It is not uncommon for medical treatment to be categorized according to two periods, specifically, an acute phase followed by a maintenance phase. The acute phase targets controlling the pain and excising necrotic tissue, teeth or bone. Also included is a regimen of antibiotics. During maintenance, treatment focuses on healing while monitoring potential pathogenic agents such as bacteria or viruses.
Lastly, a fairly new treatment intervention applied in conjunction with antibiotics. Specifically, oxygen therapy showed significant potential when used in affected individuals who were smokers.